Individual
DR. JENNIFER R. OLBUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1717 UNIVERSITY DR S, FARGO, ND 58103-4939
(701) 461-5100
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
OS008037L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1412160
—
PA
Enumeration date
06/01/2005
Last updated
09/30/2020
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